Implementing an Early Intensive Behavioral Intervention Program (EIBI): Description of Combined Approaches
Research effort has been made over the past several years to demonstrate the efficacy and the effectiveness of EIBI for young children with ASD (eg., Boyd et al., 2014; Smith et al., 2010; Eikeseth, 2009). Despite the fact that a part of the scientific community recognizes that EIBI should be favored as an intervention for young children with ASD, this assumption is nonetheless accompanied by some criticisms regarding the studies conducted. They include a poorly detailed description of the independent variables specifying the curriculum and important intervention elements (Lechago and Carr, 2008). Love et al. (2009) drew a more complete portrait of caseworkers’ EIBI practices. The authors underscore the great variability of the implemented programs. More specifically, they stress the fact that supervisors report using more than one curriculum manual, thus suggesting that none of the available curriculums meet all the needs.
The objective of this presentation is to describe the choices made by rehabilitation centers in the context of a universal community based on Early Intensive Behavioral Intervention program (EIBI) for 2 to 5 year-old children with ASD in Quebec (Canada). The approaches and strategies used by professionals are investigated to identify the most frequent and the possible combinations.
Methods: The selected model for evaluating the implementation is the one based on the program theory proposed by Chen (2015). According to Chen’s (2015) model, one of the essential components of an action plan that targets the implementation of a program and that guides its evaluation is the intervention and service delivery protocol. A questionnaire about implementation (translated and adapted from Love et al. (2009) and Gamache, Joly and Dionne (2010)) was completed by 114 stakeholders from 14 rehabilitation centers across the province. A descriptive analysis was used to examine the results obtained through the questionnaire.
When asked about the approaches used within the EIBI program, stakeholders have multiple responses. One hundred (87%) say they use Applied Behavior Analysis (ABA). Seventy-two people (62.6%) report using PECS and environmental structuring respectively, while 65 (56.5%) use sensory integration and 32 people (27.8%) use Verbal Behavior. Thirty-four respondents (29.6%) report using other intervention approaches that they do not consider to be part of the EIBI program. Among the other approaches and strategies reported, the most common is the naturalistic approach (8.7%). The combination of approaches and strategies is frequently mentioned. For the 100 people who use AAC, 66 use it in conjunction with PECS, 69 with TEACCH, 30 with Verbal Behavior and 62 with sensory integration.
This study enabled us to describe the choices made by the large majority of the centers mandated by the province of Quebec to offer a free universal EIBI program to children under 6 years of age with ASD. It confirms the diversity of choices. This study thus contributes, albeit modestly, to the advancement of the emerging Implementation Science by describing the organizations’ choices, a major, yet barely studied, link in the implementation of such complex programs.